What are cardioplegic solutions?
What are cardioplegic solutions?
Cardioplegia Solution A is a sterile, non-pyrogenic solution for cardiac perfusion in a Viaflex bag. It is used to induce cardiac stasis and to protect the myocardium during open-heart surgery. Cardioplegia Solution A is an isotonic crystalloid solution based on extracellular fluid ionic concentrations.
What is the purpose of cardioplegic solution?
Cardioplegia Solution A is a sterile, non-pyrogenic solution for cardiac perfusion in a Viaflex bag. It is used to induce cardiac stasis and to protect the myocardium during open-heart surgery.
What is del Nido solution?
The del Nido cardioplegia solution was originally developed for infant and pediatric patients and has been in use for 18 years at Boston Children’s Hospital. This cardioplegia is generally given as a single 20-mL/kg dose antegrade at 8–12°C through a recirculating delivery system.
What is Custodiol cardioplegia?
Custodiol® solution, also called histidine-tryptophan-ketoglutarate (HTK) or Bretschneider’s solution, is a particular kind of long-acting intracellular crystalloid cardioplegia (CCP) that differs from other extracellular cardioplegic solutions because of its low sodium and potassium content that induce the diastolic …
Where is cardioplegia injected?
Cardioplegia administration can be anterograde, retrograde, or both. The anterograde cardioplegia is inserted in the proximal aorta and contains three lumens: one to administer the cardioplegia, another for suctioning, and the third to measure intraluminal pressure.
What is blood cardioplegia?
The warm blood cardioplegia technique is a promising strategy in the ever-expanding field of myocardial protection. Continous WBC provides variable protection against ischemia by eliminating hypothermic myocardial ischemia and reperfusion injury.
Who invented cardioplegia?
The term cardioplegia (cardio, heart and plegia, paralysis) was first introduced by Lam in 1957 (Lam et al., 1957), yet the method of arrest has its roots in the early experiments of British physiologist Sidney Ringer using the frog heart (Figure 2).
How does del Nido cardioplegia work?
del Nido cardioplegia is delivered cold. Myocardial oxygen consumption decreases by 50% for every 10°C decrease in myocardial temperature (1,2). The del Nido cardioplegia is delivered at a temperature of 4°C and will produce myocardial cooling to less than 15°C.
What are the types of cardioplegia?
type of cardioplegia – blood cardioplegia (BL) vs. crystalloid cardioplegia (CR = St. Thomas cardioplegia + Fresenius cardioplegia) = “Cardiopl_double”; or blood cardioplegia vs. St.
Why does cardioplegia stop the heart?
Cardioplegia is an essential component of cardiopulmonary bypass and with the primary goal to reduce myocardial oxygen demand by creating electrical quiescence and cooling the heart to reduce the ischemic effects of being on bypass.
What is warm blood cardioplegia?
What is the role of K+ in cardioplegia?
Raising the K+ concentration to 16.2 mmol/l raises the resting potential to −60 mV, a level at which muscle fibers are inexcitable to ordinary stimuli. When the resting potential approaches −50 mV, sodium channels are inactivated, resulting in a diastolic arrest of cardiac activity.
When is del Nido cardioplegia solution in use?
Cardioplegia is an integral and essential method of myocardial protection for patients of all ages requiring cardiac surgery in which the heart must be stopped. Numerous cardioplegia solutions and delivery methods have been developed. The del Nido cardioplegia solution has been in use for 18 years at Boston Children’s Hospital.
What are the components of a cardioplegia solution?
Components of cardioplegia solution are varied in different institutions but include potassium to achieve diastolic arrest. A cross-clamp is applied to the ascending aorta, and the cardioplegia is administered into the aortic root in an antegrade fashion via the coronary ostia.
How is cardioplegia used in cardiopulmonary bypass?
Cardioplegia is a pharmacological therapy administered during cardiac surgery to intentionally and temporarily arrest the heart. The first solution used during cardiopulmonary bypass was reported by Dr. Melrose in the early 1950s, who identified that high levels of potassium citrate induced a revers …
How is the myocardial temperature reduced during cardioplegia?
The composition of cardioplegia solutions varies considerably; in contrast, myocardial temperature during cardioplegia is almost uniformly reduced to between 10°C and 12°C or less by the infusion of refrigerated cardioplegia and external topical cooling with ice slush.